NAHC Submits Chronic Care Recommendations to Senate Finance Committee
Better Integrate Home Health and Hospice to Achieve Superior Outcomes in Chronic Care Management
June 23, 2015 10:03 AM
The National Association for Home Care & Hospice (NAHC) today submitted recommendations to the Senate Finance Committee Chronic Care Working Group on improving care for Medicare patients with chronic conditions. Earlier this month, as previously reported, the Senate Finance Committee announced the creation of a bipartisan chronic care working group, led by Committee Chairman Orrin Hatch (R-UT) and Ranking Member Ron Wyden (D-OR), as well as Senators Johnny Isakson (R-GA) and Mark Warner (D-VA). With the purpose of assessing current law and developing policy and legislative proposals to improve chronic care, the working group sought recommendations from health care stakeholders.
NAHC submitted the recommendations in a letter from Board Chairman Denise Schrader and President Val J. Halamandaris. You can read the full letter here.
“We applaud the Committee for creating a chronic care working group seeking recommendations from health care stakeholders based on real world experience and data-driven evidence that will improve care for this vulnerable population,” Schrader and Halamandaris wrote. “With chronic disease now accounting for almost 93 percent of Medicare spending, we agree that the impact of chronic disease on the Medicare program and those it serves is staggering and must be addressed with better chronic disease management.”
In order to improve chronic care services, NAHC recommended a “broad and appropriate” role for home health services that encompasses not only post-acute care but also pre-acute care. “Our past experience and the evidence from new promising models reinforces our belief that a system that shifts chronically ill patients from inpatient services and institutional care to home and community-based settings provides the best chance at extending the fiscal viability of the Medicare program while providing high-quality, clinically appropriate services for those with chronic illness. In addition to exploring new ways to improve care for patients moving from acute settings, our members are helping keep people with chronic disease out of the hospital,” NAHC writes.
NAHC provided specific proposals to achieve evidence-based reform, including a Home-based Chronic Care Management Model. This patient-centered model is a partnership between home health agencies and patient-centered medical homes, in which the home health agency shares responsibility for patient outcomes with the primary care provider. The model has successfully reduced hospitalizations and increased patient satisfaction across the country. For example, Sutter Health in California using the model achieved a 50 percent reduction in hospitalizations and saved Medicare $118 million over a three year period. NAHC also recommended that the Committee: 1) monitor innovative programs being tested, including the Independence at Home Demonstration and the Community-based Care Transitions Program; and 2) improve care coordination for chronically ill patients as outlined in the Fostering Independence Through Technology Act of 2013 and the modernization of the Medicare home health benefit through the Home Health Care Planning Act of 2015 (S. 578).
In addition, NAHC recommended that the Committee integrate hospice care into its analysis, stating that hospice care provides a “highly valuable option” that those dealing with chronic illness should be able to consider. Specifically, NAHC endorsed the Care Planning Act of 2015 (S. 1549), which is sponsored and cosponsored by Chronic Care Working Group co-chairs Senators Warner and Isakson.
In making its recommendations, NAHC explained how home health and hospice care can help the working group achieve its stated goals to: 1) increase care coordination among individual providers across care settings who are treating patients living with chronic diseases; 2) streamline Medicare’s current payment systems to incentivize the appropriate level of care for patients living with chronic diseases; and 3) facilitate the delivery of high quality care, improve care transitions, produce stronger patient outcomes, increase program efficiency, and contributes to an overall effort that will reduce the growth in Medicare spending.
The Senate Finance Committee Chronic Care Working Group intends to develop legislative proposals based on the recommendations it receives. NAHC Report will continue to provide updates regarding the status of any such legislative effort.